Swimming exercise ameliorates multiple sclerosis-induced impairment of short-term memory by suppressing apoptosis in the hippocampus of rats

Jin, Jun-Jang,Ko, Il-Gyu,Kim, Sung-Eun,Shin, Mal-Soon,Kim, Sang-Hoon,Jee, Yong-Seok Korean Society of Exercise Rehabilitation 2014 JER Vol.10 No.2

<P>Multiple sclerosis is one of the autoimmune diseases in the central nervous system. Multiple sclerosis occurs through multiple mechanisms, and it is also mediated in part by an apoptotic mechanism. Swimming exercise has been recommended for the prevention and treatment of chronic diseases. In the present study, we investigated the effects of swimming exercise on short-term memory in relation with apoptotic neuronal cell death in the hippocampus following induction of multiple sclerosis. For this study, step-down avoidance task, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, immunohistochemistry for caspase-3 were performed. The animal model of multiple sclerosis was made by bilateral intracerebral ventricle injection of ethidium bromide. The rats in the swimming exercise groups were forced to swim for 30 min once daily for 14 consecutive days, starting 3 days after induction of multiple sclerosis. In the present results, short-term memory was deteriorated in the multiple sclerosis-induced rats. The number of TUNEL-positive and caspase-3-positive cells in the hippocampal dentate gyrus was increased in the multiple sclerosis-induced rats. Swimming exercise alleviated multiple sclerosis-induced short-term memory impairment by suppressing apoptotic neuronal cell death in the hippocampus. These effects of swimming exercise may aid symptom relief in the incurable neurodegenerative diseases.</P>

The Emerging Role of Zinc in the Pathogenesis of Multiple Sclerosis

Choi, Bo Young,Jung, Jong Won,Suh, Sang Won MDPI AG 2017 INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES Vol.18 No.10

<P>Our lab has previously demonstrated that multiple sclerosis-induced spinal cord white matter damage and motor deficits are mediated by the pathological disruption of zinc homeostasis. Abnormal vesicular zinc release and intracellular zinc accumulation may mediate several steps in the pathophysiological processes of multiple sclerosis (MS), such as matrix metallopeptidase 9 (MMP-9) activation, blood-brain barrier (BBB) disruption, and subsequent immune cell infiltration from peripheral systems. Oral administration of a zinc chelator decreased BBB disruption, immune cell infiltration, and spinal white matter myelin destruction. Therefore, we hypothesized that zinc released into the extracellular space during MS progression is involved in destruction of the myelin sheath in spinal cord white mater and in generation of motor deficits. To confirm our previous study, we employed zinc transporter 3 (<I>ZnT3</I>) knockout mice to test whether vesicular zinc depletion shows protective effects on multiple sclerosis-induced white matter damage and motor deficits. <I>ZnT3</I> gene deletion profoundly reduced the daily clinical score of experimental autoimmune encephalomyelitis (EAE) by suppression of inflammation and demyelination in the spinal cord. <I>ZnT3</I> gene deletion also remarkably inhibited formation of multiple sclerosis-associated aberrant synaptic zinc patches, MMP-9 activation, and BBB disruption. These two studies strongly support our hypothesis that zinc release from presynaptic terminals may be involved in multiple sclerosis pathogenesis. Further studies will no doubt continue to add mechanistic detail to this process and with luck, clarify how these observations may lead to development of novel therapeutic approaches for the treatment of multiple sclerosis.</P>

다발성 경화증 환자 5례에 대한 임상보고

강계성,권기록,Kang, Kye-sung,Kwon, Ki-rok 대한침구의학회 2003 대한침구의학회지 Vol.20 No.1

Background : Multiple Sclerosis is characterized by chronic inflammation, demyelinization and neurogliosis(plaque) in optic nerve, brain and spinal cord, which is recurrent visual disturbance, sensory disturbance, motor disturbance and sphincter disturbance, etc. Objective : This study was performed to evaluate the treatment of acupuncture therapy including Herbal Acupuncture and Bee venom Herbal Acupuncture in Multiple Sclerosis. Methods : We treated 5 cases of Multiple Sclerosis patients with mainly Bee venom Herbal Acupuncture therapy, and herbal Acupuncture, sa-am acupuncture form 18th september, 2001 to december, 2002. Results : 1 Of 5 cases who were treated with above, 3 patients were mildly reduced symptoms and 2 patients were no changes. 2. There are two patients who were definitely appeared the recurrent symptoms on treatment period, but decreased the remission period than before. 3. It has not shown noticeable recurrent symptoms of 3 patients. Conclusions : Bee Venom Herbal Acupuncture therapy and other acupuncture therapies were effective in reducing the recurrent symptoms and remission perod, but it was not evaluated the chief complaints on 5 cases of Multiple Sclerosis. We think that it need the further study and clinical trial for Multiple Sclerosis and other neurological diseases.

Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka

Sujani Madhurika Kodagoda Gamage,Indunil Wijeweera,Priyangi Wijesinghe,Sanjaya Bandara Adikari,Katharina Fink,Herath Mudiyanselage Ajith Sominanda 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.3

Background and Purpose The magnetic resonance imaging in multiple sclerosis (MAGNIMS) group recently proposed guidelines to replace the existing dissemination-in-space criteria in McDonald 2010 magnetic resonance imaging (MRI) criteria for diagnosing multiple sclerosis. There has been insufficient research regarding their applicability in Asians. Objective of this study was to determine the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of McDonald 2010 and MAGNIMS 2016 MRI criteria with the aim of verifying their applicability in Sri Lankan patients. Methods Patients with clinically isolated syndrome diagnosed by consultant neurologists were recruited from five major neurology centers. Baseline and follow-up MRI scans were performed within 3 months from the initial presentation and at one year after baseline MRI, respectively. McDonald 2010 and MAGNIMS 2016 MRI criteria were applied to all MRI scans. Patients were followed-up for 2 years to assess the conversion to clinically definite multiple sclerosis (CDMS). The sensitivity, specificity, accuracy, PPV, and NPV for predicting the conversion to CDMS were calculated. Results Forty-two of 66 patients converted to CDMS. Thirty-seven fulfilled the McDonald 2010 MRI criteria, and 33 converted to CDMS. MAGNIMS 2016 MRI criteria were fulfilled by 29, with 28 converting to CDMS. The sensitivity, specificity, accuracy, PPV, and NPV were 78%, 83%, 64%, 89%, and 69%, respectively, for the McDonald 2010 criteria, and 67%, 96%, 77%, 96%, and 62% for the MAGNIMS 2016 MRI criteria. Conclusions MAGNIMS 2016 MRI criteria were superior to McDonald 2010 MRI criteria in specificity, accuracy, and PPV, but inferior in sensitivity and NPV.

Swimming Exercise Ameliorates Symptoms of MOG-Induced Experimental Autoimmune Encephalomyelitis by Inhibiting Inflammation and Demyelination in Rats

김지연,이은석,이현주,김준수,지용석,김성은,김창주,고일규 대한배뇨장애요실금학회 2020 International Neurourology Journal Vol.24 No.S1

Purpose: Multiple sclerosis is an autoimmune disease that affects the central nerve system, resulting in cumulative loss of motor function. Multiple sclerosis is induced through multiple mechanisms and is caused by inflammation and demyelination. This study aims to evaluate the neuroprotective effect of swimming exercise in experimental autoimmune encephalomyelitis (EAE) rats, an animal model of multiple sclerosis.Methods: EAE was induced by an intradermal injection of 50-μg purified myelin oligodendrocyte glycoprotein 33–55 (MOG_33-55) dissolved in 200-μL saline at the base of the tail. The rats in the swimming exercise group were made to swim for 30 minutes once pert a day for 26 consecutive days, starting 5 days after induction of EAE. To compare the effect of swimming exercise with interferon-β, a drug for multiple sclerosis, interferon-β was injected intraperitoneally into rats of the EAE-induced and interferon-β-treated group during the exercise period.Results: Injection of MOG_33-55 caused weight loss, decreased clinical disability score, and increased level of pro-inflammatory cytokines and inflammatory mediators in the lumbar spinal cord. Loss of motor function and weakness increased demyelination score. Swimming exercise suppressed demyelination and expression of pro-inflammatory cytokines and inflammatory mediators. These changes promoted recovery of EAE symptoms such as body weight loss, motor dysfunction, and weakness. Swimming exercise caused the same level of improvement as interferon-β treatment.Conclusions: The results of this experiment suggest the possibility of swimming exercise in urological diseases that are difficult to treat. Swimming exercises can be considered for relief of symptom in incurable multiple sclerosis.

Optic Neuritis as First Manifestation of Multiple Sclerosis: A Case Report

( Hoon Dong Kim ),( Jai Ho Choi ) 국군의무사령부 2012 대한군진의학학술지 Vol.43 No.1

시신경염은 다발성 경화증의 가장 중요한 임상 증상 중의 하나로 나타날 수 있다. 저자들은 젊은 남자 환자에서 다른 신경학적 이상 증세 및 징후 없이 구후 시신경염 양상만을 보인 환자에서 다발성 경화증으로 진단된 증례를 군병원에서 처음으로 경험하였기에 이를 보고하고자 한다. 내원 1주일 전부터 발생한 좌안의 갑작스런 시력 저하 주소로 국군강릉병원 안과 내원한 18세 남자 환자로, 구심성 동공장애, 색각 이상 소견 관찰되었다. 시야 검사 상 비특이적인 시야 결손 양상 보였으며, 안저 검사 상 시신경 유두의 종창은 관찰되지 않았다. 반면에, 전신소견 상 두통, 운동 실조, 감각 이상 등의 다른 신경학적 이상 소견은 나타나지 않았다. 입원 후 시행한 자기공명영상에서 대뇌 반구, 교뇌, 연수, 등의 부위에서 다발성의 높은 신호 강도를 보이는 병변 관찰되었다. 그 결과, 본 환자 다발성 경화증 진단 하에 고용량 스테로이드 치료를 시행하였다. 이에 따라, 다른 신경학적 증상 또는 징후가 없다고 하더라도, 시신경염 환자를 진료할 경우 반드시 다발성 경화증의 동반가능성을 항상 염두에 두고 진료를 해야 한다고 생각한다. Optic neuritis is one of the most important clinical manifestation associated with multiple sclerosis. We experienced a case of retrobulbar optic neuritis as the first manifestation of multiple sclerosis in young man without specific neurologic symptom or sign. A 18-years-old man suffered from loss of vision in the left eye before a week was visited our hospital. He had relative afferent pupillary defect, color blindness, and non-specific visual field defect without optic disc swelling. On the other hand, the patient didn't present any neurologic symptoms including headache, motor weakness, or paresthesia. On T2-weighted images of the brain magnetic resonance imaging (MRI) scan, multiple lesions with high signal density were found on cerebral hemisphere, pons, and medulla. As a result, the patient was diagnosed as multiple sclerosis, and the treatment with high dose steroid was started. We should keep in mind that multiple sclerosis can be revealed as optic neuritis without other neurologic symptom or sign, and meticulous evaluation is needed for the patients with optic neuritis.

Systemic Lupus Erythematosus를 동반한 Multiple sclerosis

이지현,이기주,윤성호,부귀범,손현화,박유환,정춘해,김진호,정원영 조선대학교 부설 의학연구소 1998 The Medical Journal of Chosun University Vol.23 No.2

Multiple sclerosis and lupus erythematosus are chronic, potentially disabling diseases of unknown cause. It is a rare occasion that the finding of both diseases occurs in one patient. Because both diseases may affect the central nervous system, it may be difficult at times to differentiate symptoms of lupus erythematosus from those of multiple sclerosis. As far as we know, there was no case report of SLE in multilple sclerosis in Korea. We report a case of multiple sclerosis accompanied by SLE.

14세 여아에서 다발경화증을 동반한 1과 1/2 증후군

임연주(Yeon Ju Lim),이수정(Soo Jung Lee) 대한안과학회 2021 대한안과학회지 Vol.62 No.8

Purpose: To report the case of a 14-year-old female patient with one-and-a-half syndrome subsequently diagnosed with multiple sclerosis involving the pons. Case summary: A 14-year-old girl without any underlying disease presented with difficulty focusing and mild headache for 5 days. The patient showed conjugate gaze palsy to the left, limited adduction in the left eye, and abducting nystagmus in the right eye, which indicated one-and-half syndrome. T2 fluid-attenuated inversion recovery brain magnetic resonance imaging revealed multiple punctate hyperintensities in the pontine tegmentum, bilateral cerebral white matter, and cerebellum. Cerebrospinal fluid examination revealed oligoclonal bands and multiple sclerosis was diagnosed. The patient was treated with intravenous steroids and beta-interferon. Seven weeks later, limitation of eyeball movement and nystagmus had resolved completely. Conclusions: At the young age of 14 years, a patient presenting with one-and-a-half syndrome was diagnosed with multiple sclerosis. Children with multiple sclerosis may experience severe physical and cognitive impairments, and brainstem involvement predicts an especially poor prognosis. Early diagnosis and active treatment may help to prevent poor outcomes. 목적: 14세의 어린 연령에서 1과 1/2 증후군이 발생한 환자에서 다리뇌를 침범한 다발경화증이 원인으로 밝혀진 1예를 보고하고자 한다. 증례요약: 특이 과거력이 없는 14세 여자 환자가 5일 전부터 경미한 두통을 동반한 초점이 잘 안 맞는 증상으로 내원하였다. 눈운동검사에서 좌측주시 제한 및 좌안의 내전제한이 있었고 우안 외전시 가쪽눈떨림(abducting nystagmus)이 관찰되었다. 1과 1/2 증후군을 의심하여 촬영한 뇌자기공명영상의 T2 fluid attenuated inversion recovery 영상에서 다리뇌 뒤판과 양측 뇌백질 및 소뇌에서 다수의 고강도 신호 병변이 관찰되었고, 뇌척수액검사에서 올리고클론띠(oligoclonal band) 양성이 나와 다발경화증으로 진단되었다. 스테로이드 정맥주사와 인터페론 베타를 투여하였고 초진 7주 후 눈운동장애와 눈떨림은 보이지 않았다. 결론: 14세의 어린 연령에서 1과 1/2 증후군을 보이는 환자에서 원인이 다발경화증으로 진단된 1예를 확인하였으며, 소아 다발경화증 환자에서 병변이 뇌간을 침범하였을 경우에는 예후가 나쁠 수 있으므로 조기에 진단하여 적극적인 치료를 하는 것이 필요하다.

Validity and Reliability of the World Health Organization Disability Assessment Schedule 2.0 36-Item Persian Version for Persons with Multiple Sclerosis

Reza Salehi,Hossein Negahban,Farzad Faraji Khiavi,Shiva Saboor,Nastaran Majdinasab,Kamal Shakhi 대한가정의학회 2020 Korean Journal of Family Medicine Vol.41 No.3

Background: No previous studies have assessed the psychometric properties of the 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in the Persian language of Iran. This study was designed and conducted to evaluate the validity and reliability of the Persian version using a sample of persons with multiple sclerosis in Ahvaz, Iran. Methods: The methodological study was conducted in two stages: First, the 36 items of the original WHODAS 2.0 were translated to create a Persian version, after which the translation validity and psychometric properties were tested. The factor structure of the instrument was also tested using exploratory and confirmatory factor analyses. Results: The intraclass correlation coefficients were very good to excellent, varying between 0.82 and 0.99 for the six domains, and all domains had Cronbach’s α reliability values of above 0.70. For construct validity, results showed negative and strong correlation between the total score of WHODAS 2.0 and the Multiple Sclerosis Quality of Life- 54. Exploratory factor analysis divided the Persian version of WHODAS 2.0 into seven factors for multiple sclerosis patients. Conclusion: The results of this study indicate that the Persian version of WHODAS 2.0 is a valid and reliable instrument to study the disabilities of people with multiple sclerosis.

소아 급성 시신경염

구남향(Nam Hyang Koo),김연희(Yeun Hee Kim),김성환(Sung Hwan Kim) 대한소아신경학회 2004 대한소아신경학회지 Vol.12 No.2

목적 : 급성 시신경염은 시신경 수초의 염증이나 탈수초화로 인해 발생하는 시신경 질환으로 소아 급성 시신경염은 임상 양상과 예후가 성인과 차이를 보이는 것으로 알려져 있다. 그러나 소아에서 발생한 급성 시신경염은 성인에 비해 발생빈도가 적어서 임상 증상, 스테로이드 치료 후 시력 예후, 시신경염의 재발 및 다발성 경화증으로 이행에 대한 체계적인 연구가 결여되어 있다. 성인에서 시행된 ONTT의 연구 결과는 그대로 소아에 적용하기에는 문제가 있기에 저자들은 소아에서 발생한 급성 시신경염의 원인, 임상 양상, 시력 예후 및 시신경염의 재발과 다발성 경화증으로의 이행 여부를 알아보고자 본 연구를 시행하였다. 방법 : 1995년 1월부터 2004년 4월까지 아주대학교병원 소아과에서 급성 시신경염으로 진단 받은 15세 이하 소아 환자 10명의 의무기록을 토대로 시신경염의 원인, 임상 양상 및 단기 시력 예후에 대해 후향적 조사를 하였다. 또한 고용량 methyl-prednisone으로 치료한 9명의 환자에서 퇴원 후 30개월 간 장기 시력 예후, 시신경염의 재발 및 다발성 경화증으로 이행 여부를 추적 관찰하였다. 결과 : 10명의 환아 중 남아 4명, 여아가 6명이었으며 평균 연령은 10세였다. 전체 환자 10명 중 8명에서 시신경염이 양쪽 눈에 발생하였고 나머지 2명은 한쪽 눈에만 발생하였으며 90%의 환자는 유두염 소견을 보였다. 소아 급성 시신경염의 원인은 특발성 시신경염이 50%로 가장 많았으며, 급성 파종성 뇌척수염 30%, 전부비동염과 시신경 척수염이 각각 10%이었다. 시신경 자기공명영상 검사를 시행한 10명 환자의 18안 중 15안에서 시신경비대 및 조영증강과 유두돌출 소견을 보였다. 시간유발전위 검사상 8명 환자 16안 중 12안(75%)에서 이상 소견이 관찰되었다. 이상 소견이 발견되었던 12안 중 6안은 P100파의 진폭이 약화되어 P100파를 측정할 수 없었고 나머지 6안은 P100파의 진폭은 정상이었으나 잠시가 지연되었다. 스테로이드 치료 1개월 후 추적 조사한 시각 유발전위 검사에서 P100파의 진폭은 모두 정상으로 회복되었으나 60%의 환자는 P100파의 잠시가 여전히 지연되어 있었다. 고용량 스테로이드 치료 후 8명 환자의 15안 중 14안에서 단기 시력이 정상으로 회복되었다. 고용량 스테로이드로 치료받은 9명의 환자 중 1명(11%)에서 시신경염이 재발하였으나 다발성 경화증으로 이행된 환자는 없었다. 결론 : 소아에서 발생한 급성 시신경염은 특발성 시신경염이 가장 흔한 원인이며 주로 양쪽 눈에 유두염으로 나타나는 특성이 있다. 본 연구는 다른 보고와 달리 고용량 스테로이드 치료 후 단기 시력 예후는 아주 좋았고, 치료 6개월 후 측정한 장기 시력 예후는 단기 시력 예후와 차이가 없었다. 대부분의 소아 시신경염 환자에서 시신경염 환자에서 시신경염이 재발하거나 다발성 경화증으로 이행되지 않아 예후는 양호하였으나 더 많은 환자를 대상으로 장기간 추적 관찰을 통한 전향적 연구가 필요한 것으로 생각된다. Purpose: Acute optic neuritis is an inflammatory optic neuropathy, and rarely occurs in children. Childhood-onset optic neuritis is different from adult-onset optic neuritis in terms of clinical and prognostic aspects. We investigated the clinical characteristics and visual prognosis related to the steroid therapy in children with acute optic neuritis. In addition, we evaluated the recurrence rate of acute optic neuritis and subsequent evolution into multiple sclerosis. Methods: The medical records of ten children, who were previously admitted for acute optic neuritis at the Department of Pediatrics of Ajou University Medical Center from January 1995 to April 2004, were retrospectively reviewed. Nine patients were treated with intravenous methylprednisone pulse therapy, 0.5-1.0 g/day, for 3-5 days followed by an oral prednisone therapy. To 30 months after discharge, we followed up a long-term visual prognosis, recurrence rate and subsequent evolution into multiple sclerosis. Results: There were 4 boys and 6 girls and the mean age of onset was 10 years. Bilateral optic neuritis was noticed in 8 children and 9 children presented with papillitis. Etiology of acute optic neuritis was idiopathic in 50% of patients. Of the remaining cases, it was related with acute disseminated encephalomyelitis(30%), sinusitis(10%), and neuromyelitis optica(10%). Orbital MRI showed optic nerve enhancement and/or enlargement and optic disc protrusion in 15 of the 18 examined eyes. Visual evoked potential (VEP) was abnormal in 12 of the 16 examined eyes; P100 response was totally attenuated in 6 eyes, and in the others the amplitude of P100 response was normal but the latency was delayed. On follow-up VEP at 1 month after steroid pulse therapy, the amplitude of P100 response was normalized in all, but the latency was still delayed in 60% of the patients. A short-term visual acuity after treatment with steroid was normally recovered in 14 of 15 involved eyes. Acute optic neuritis recurred in one of the nine patients who were treated with high dose methyl prednisone pulse therapy, but there was no subsequent development of multiple sclerosis during the follow up. Conclusions: The most common cause of acute optic neuritis in children is idiopathic, and presents as bilateral papillitis. On this study, a short-term visual prognosis after high dose methylprednisone pulse therapy is extremely good, but there was no significant difference in long-term visual prognosis at 6 months after treatment with steroid. Acute optic neuritis in children does not usually recur, and does not evolve into multiple sclerosis.